Pretransplant Prediction of Posttransplant Survival for Liver Recipients with Benign End-Stage Liver Diseases A Nonlinear Model 英文参考文献.docVIP

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Pretransplant Prediction of Posttransplant Survival for Liver Recipients with Benign End-Stage Liver Diseases A Nonlinear Model 英文参考文献.doc

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Pretransplant Prediction of Posttransplant Survival for Liver Recipients with Benign End-Stage Liver Diseases A Nonlinear Model 英文参考文献

PretransplantPredictionofPosttransplantSurvivalfor LiverRecipientswithBenignEnd-StageLiverDiseases:A NonlinearModel MingZhang1,2.,FeiYin3.,BoChen4,YouPingLi2,LuNanYan1,TianFuWen1,BoLi1* 1LiverTransplantationCenter,WestChinaHospital,SichuanUniversityMedicalSchool,Chengdu,People’sRepublicofChina,2ChineseCochraneCenterandChinese Evidence-BasedMedicineCenter,WestChinaHospital,SichuanUniversityMedicalSchool,Chengdu,People’sRepublicofChina,3DepartmentofBiostatistics,WestChina SchoolofPublicHealth,SichuanUniversity,Chengdu,People’sRepublicofChina,4DepartmentofMedicalInformatics,WestChinaHospital,SichuanUniversityMedical School,Chengdu,People’sRepublicofChina Abstract Background: The scarcity of grafts available necessitates a system that considers expected posttransplant survival, in additiontopretransplantmortalityasestimatedbytheMELD.Sofar,however,conventionallineartechniqueshavefailedto achievesufficientaccuracyinposttransplantoutcomeprediction.Inthisstudy,weaimtodevelopapretransplantpredictive model for liver recipients’ survival with benign end-stage liver diseases (BESLD) by a nonlinear method based on pretransplantcharacteristics,andcompareitsperformancewithaBESLD-specificprognosticmodel(MELD)andageneral- illnessseveritymodel(thesequentialorganfailureassessmentscore,orSOFAscore). Methodology/Principal Findings: With retrospectively collected data on 360 recipients receiving deceased-donor transplantationforBESLDbetweenFebruary1999andAugust2009inthewestChinahospitalofSichuanuniversity,we developed a multi-layer perceptron (MLP) network to predict one-year and two-year survival probability after transplantation.TheperformancesoftheMLP,SOFA,andMELDwereassessedbymeasuringbothcalibrationabilityand discriminative power, with Hosmer-Lemeshow test and receiver operating characteristic analysis, respectively. By the + forward stepwise selection, donor age and BMI; serum concentration of HB, Crea, ALB, TB, ALT, INR, Na ; presence of pretransplant diabetes; dialysis prior